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Obsessive-Compulsive Disorder: Should I Take Medicine for OCD?

You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.

Medicines called antidepressants can help balance the chemicals in your brain
and reduce your symptoms. Antidepressant medicines called selective serotonin
reuptake inhibitors (SSRIs), such as fluoxetine (for example, Prozac), are most
commonly used.

Your doctor may increase the amount you take or may
switch you to another SSRI if the first one doesn't help or if it causes side
effects you can't live with.

You may start to feel better within 1
to 3 weeks after you start to take antidepressant medicine. But it can take as
many as 12 weeks to see more improvement. If you have questions or concerns
about your medicines, or if you do not notice any improvement by 3 weeks, talk
to your doctor.

Your medicine may cause side effects, but they
will probably go away after your body gets used to the drug. Common side
effects include:

Nausea.

Appetite changes or
weight loss.

Headaches.

Trouble sleeping and
tiredness.

Nervousness.

Loss of sexual desire or
ability, and delayed orgasm.

Dizziness or shakiness
(tremor).

The U.S. Food and Drug Administration (FDA) has issued an advisory on antidepressant medicines and the risk of suicide. Talk to your doctor about these possible side effects and the warning signs of suicide.

Women who take an SSRI during pregnancy may have a slightly higher chance of having a baby with birth defects. If you are pregnant, you and your doctor must weigh the risks of taking an SSRI against the risks of not treating OCD.

If
you have mild symptoms, you may be able to control OCD with a type of
counseling called
exposure and response prevention. This is a form of
cognitive-behavioral therapy.

With this type of counseling, you gradually
increase your contact with the feared obsession so that you have less anxiety
about it. For example, if you were obsessed about germs, you would repeatedly
touch an object you believe has germs and then not wash your hands afterward.
You would repeat that behavior until you felt less anxious about
it.

Counseling may also help you think about your beliefs in a new
way. For example, if you are a person who washes your hands over and over
because you believe germs will harm you, counseling could help you see that you
don't need to be afraid.

Your symptoms get in the way of your ability to work and have
relationships.

Counseling has not helped control your thoughts and
behaviors well enough for you to live with them.

Compare your options

Compare

What is usually involved?

What are the benefits?

What are the risks and side effects?

Take medicine for OCD
Take medicine for OCD

You take medicine once or twice
every day or on certain days of the month.

You still visit a
counselor regularly.

Research shows that certain
antidepressants improve symptoms of OCD and help balance brain chemicals.

Medicine may cause
side effects such as nausea, headache, nervousness, or trouble sleeping.

Use counseling only
Use counseling only

You visit a counselor regularly.
You may need as many as 13 to 20 sessions to relieve your symptoms.

Research shows that counseling
helps many people with OCD.

Counseling alone
may not be enough to help your symptoms.

Personal stories about taking medicines to treat OCD

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

I constantly
wash my hands. Sometimes even after I have just washed my hands, I feel my
hands may not be clean, and so I wash them again. If I touch a public doorknob,
shake hands with someone, or touch something another person may have touched, I
worry about germs or dirt and feel the need to wash my hands. This behavior is
interfering with my life. I think medicines may help control the urge to wash
my hands while I continue with professional counseling to learn how to stop
this behavior.

Jesse,
age 41

I like to have things in my home and office
in place and neat. I worry a few times throughout the day whether I left an
appliance on or the doors unlocked in my home. I check the locks a few times
before I go to work, but I'm not usually late for work due to checking the
locks. I don't think the behaviors are interfering in my daily living too much
yet. I think I will try to control these worries through professional
counseling only.

Kyle,
age 28

I worry all the time about my grades at
school and how other people see me. I tend to rewrite my papers for school
numerous times before I feel like they are good enough to turn in, especially
if any of my writing looks messy. I take several showers a day because I worry
about how I look. I have also stopped eating in hopes of losing some weight
because I worry I weigh too much. In the mornings when I wake up, I can't get
out of bed until I have prayed for every family member and friend because I am
afraid something bad might happen to them if I forget to pray. If I forget
someone, I have to start my prayers all over again, and this often makes me
late for school. I have been seeing a professional counselor, but I think I
might get more out of counseling if I take medicines that can help me control
these urges.

Jasmine,
age 17

I spend most of my day reorganizing
cupboards and closets in my house. I just can't seem to get them clean enough.
I am still able to tend to my children during the day, but when they are
napping, I usually spend that time cleaning my house again. I also sometimes
think that my buttons are not done up on my clothes and check those throughout
the day. But I can usually stop thinking about my buttons and whether the
house is clean when I am involved with my children or have other commitments
during the day. I think I will talk with someone about how to resist these
urges before they get out of hand, but I don't think I need medicines yet.

Carla, age
38

What matters most to you?

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to take medicine for OCD

Reasons not to take medicine for OCD

I want to do whatever I can to get rid of my obsessions and compulsions.

I can deal with my obsessions and compulsions on my own.

More important

Equally important

More important

I'm willing to try medicine, because I think it will help ease my symptoms and anxiety from OCD.

I think the side effects of the medicine would bother me more than my symptoms and anxiety do.

More important

Equally important

More important

I don't feel that counseling is helping my symptoms enough.

I'm happy with the way counseling is helping my symptoms.

More important

Equally important

More important

My other important reasons:

My other important reasons:

More important

Equally important

More important

Where are you leaning now?

Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

Taking medicine for OCD

NOT taking medicine for OCD

Leaning toward

Undecided

Leaning toward

What else do you need to make your decision?

Check the facts

1.

I may not need to take medicine for OCD if my symptoms are mild.

TrueThat's right. Counseling alone often works to control OCD in people who have only mild symptoms.

FalseSorry, that's not right. Counseling alone often works to control OCD in people who have only mild symptoms.

I'm not sureIt may help to go back and read "Get the Facts." Counseling alone often works to control OCD in people who have only mild symptoms.

2.

My decision may depend on whether my symptoms bother me more than the side effects from the medicine would.

TrueThat's right. You will want to weigh which bothers you more—the side effects of the medicines or your symptoms and anxiety from OCD.

FalseSorry, that's not right. You will want to weigh which bothers you more—the side effects of the medicines or your symptoms and anxiety from OCD.

I'm not sureIt may help to go back and read "Get the Facts." You will want to weigh which bothers you more—the side effects of the medicines or your symptoms and anxiety from OCD.

Patient choices

You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.

Obsessive-Compulsive Disorder: Should I Take Medicine for OCD?

Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.

Get the facts

Compare your options

What matters most to you?

Where are you leaning now?

What else do you need to make your decision?

1. Get the Facts

Your options

Use medicine to help control your
obsessive-compulsive behaviors.

Use counseling only.

Key points to remember

If your symptoms are mild, you can try a type of counseling
called
exposure and response prevention to help control your
OCD without medicine.

If your symptoms are severe, medicines
(antidepressants) will usually be prescribed first. You may want to start
counseling at the same time or soon after you begin
medicines.

Antidepressants must be taken as prescribed. If you
don't take them regularly, or if you stop taking them, your OCD thoughts and
behaviors will probably return.

Antidepressants have some side
effects. You may need to try taking different amounts or a different type to
find what works best. Many side effects go away a few weeks after treatment
starts.

You may need to decide which bothers you more—the side
effects of the medicines or your symptoms and anxiety from OCD.

FAQs

What is obsessive-compulsive disorder?

Obsessive-compulsive disorder (OCD) is a potentially disabling
anxiety disorder. A person who has
OCD has intrusive and unwanted thoughts and repeatedly
performs tasks to get rid of the thoughts.

For example, if you
have OCD, you may fear that everything you touch has germs. And in order to
ease that fear, you repeatedly wash your hands.

The effects of
OCD range from mild to very serious. Treatment can help. And although some
symptoms may continue after treatment, you can go on to have an active social
life, raise a family, and work.

What can you expect if you take medicine?

Medicines called antidepressants can help balance the chemicals in your brain
and reduce your symptoms. Antidepressant medicines called selective serotonin
reuptake inhibitors (SSRIs), such as fluoxetine (for example, Prozac), are most
commonly used.

Your doctor may increase the amount you take or may
switch you to another SSRI if the first one doesn't help or if it causes side
effects you can't live with.

You may start to feel better within 1
to 3 weeks after you start to take antidepressant medicine. But it can take as
many as 12 weeks to see more improvement. If you have questions or concerns
about your medicines, or if you do not notice any improvement by 3 weeks, talk
to your doctor.

Your medicine may cause side effects, but they
will probably go away after your body gets used to the drug. Common side
effects include:

Nausea.

Appetite changes or
weight loss.

Headaches.

Trouble sleeping and
tiredness.

Nervousness.

Loss of sexual desire or
ability, and delayed orgasm.

Dizziness or shakiness
(tremor).

The U.S. Food and Drug Administration (FDA) has issued an advisory on antidepressant medicines and the risk of suicide. Talk to your doctor about these possible side effects and the warning signs of suicide.

Women who take an SSRI during pregnancy may have a slightly higher chance of having a baby with birth defects. If you are pregnant, you and your doctor must weigh the risks of taking an SSRI against the risks of not treating OCD.

What can you expect if you don't take medicine?

If
you have mild symptoms, you may be able to control OCD with a type of
counseling called
exposure and response prevention. This is a form of
cognitive-behavioral therapy.

With this type of counseling, you gradually
increase your contact with the feared obsession so that you have less anxiety
about it. For example, if you were obsessed about germs, you would repeatedly
touch an object you believe has germs and then not wash your hands afterward.
You would repeat that behavior until you felt less anxious about
it.

Counseling may also help you think about your beliefs in a new
way. For example, if you are a person who washes your hands over and over
because you believe germs will harm you, counseling could help you see that you
don't need to be afraid.

Why might your doctor recommend taking medicine for OCD?

Your doctor might recommend medicine if:

Your symptoms get in the way of your ability to work and have
relationships.

Counseling has not helped control your thoughts and
behaviors well enough for you to live with them.

2. Compare your options

Take medicine for OCD

Use counseling only

What is usually involved?

You take medicine once or twice
every day or on certain days of the month.

You still visit a
counselor regularly.

You visit a counselor regularly.
You may need as many as 13 to 20 sessions to relieve your symptoms.

What are the benefits?

Research shows that certain
antidepressants improve symptoms of OCD and help balance brain chemicals.

Research shows that counseling
helps many people with OCD.

What are the risks and side effects?

Medicine may cause
side effects such as nausea, headache, nervousness, or trouble sleeping.

Counseling alone
may not be enough to help your symptoms.

Personal stories

Are you interested in what others decided to do? Many people have faced this decision. These
personal stories
may help you decide.

Personal stories about taking medicines to treat OCD

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

"I constantly wash my hands. Sometimes even after I have just washed my hands, I feel my hands may not be clean, and so I wash them again. If I touch a public doorknob, shake hands with someone, or touch something another person may have touched, I worry about germs or dirt and feel the need to wash my hands. This behavior is interfering with my life. I think medicines may help control the urge to wash my hands while I continue with professional counseling to learn how to stop this behavior."

— Jesse,
age 41

"I like to have things in my home and office in place and neat. I worry a few times throughout the day whether I left an appliance on or the doors unlocked in my home. I check the locks a few times before I go to work, but I'm not usually late for work due to checking the locks. I don't think the behaviors are interfering in my daily living too much yet. I think I will try to control these worries through professional counseling only."

— Kyle,
age 28

"I worry all the time about my grades at school and how other people see me. I tend to rewrite my papers for school numerous times before I feel like they are good enough to turn in, especially if any of my writing looks messy. I take several showers a day because I worry about how I look. I have also stopped eating in hopes of losing some weight because I worry I weigh too much. In the mornings when I wake up, I can't get out of bed until I have prayed for every family member and friend because I am afraid something bad might happen to them if I forget to pray. If I forget someone, I have to start my prayers all over again, and this often makes me late for school. I have been seeing a professional counselor, but I think I might get more out of counseling if I take medicines that can help me control these urges."

— Jasmine,
age 17

"I spend most of my day reorganizing cupboards and closets in my house. I just can't seem to get them clean enough. I am still able to tend to my children during the day, but when they are napping, I usually spend that time cleaning my house again. I also sometimes think that my buttons are not done up on my clothes and check those throughout the day. But I can usually stop thinking about my buttons and whether the house is clean when I am involved with my children or have other commitments during the day. I think I will talk with someone about how to resist these urges before they get out of hand, but I don't think I need medicines yet."

— Carla, age
38

3. What matters most to you?

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to take medicine for OCD

Reasons not to take medicine for OCD

I want to do whatever I can to get rid of my obsessions and compulsions.

I can deal with my obsessions and compulsions on my own.

More important

Equally important

More important

I'm willing to try medicine, because I think it will help ease my symptoms and anxiety from OCD.

I think the side effects of the medicine would bother me more than my symptoms and anxiety do.

More important

Equally important

More important

I don't feel that counseling is helping my symptoms enough.

I'm happy with the way counseling is helping my symptoms.

More important

Equally important

More important

My other important reasons:

My other important reasons:

More important

Equally important

More important

4. Where are you leaning now?

Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

Taking medicine for OCD

NOT taking medicine for OCD

Leaning toward

Undecided

Leaning toward

5. What else do you need to make your decision?

Check the facts

1.
I may not need to take medicine for OCD if my symptoms are mild.

True

False

I'm not sure

That's right. Counseling alone often works to control OCD in people who have only mild symptoms.

2.
My decision may depend on whether my symptoms bother me more than the side effects from the medicine would.

True

False

I'm not sure

That's right. You will want to weigh which bothers you more—the side effects of the medicines or your symptoms and anxiety from OCD.

Decide what's next

1.
Do you understand the options available to you?

Yes

No

2.
Are you clear about which benefits and side effects matter most to you?

Yes

No

3.
Do you have enough support and advice from others to make a choice?

Yes

No

Certainty

1.
How sure do you feel right now about your decision?

Not sure at all

Somewhat sure

Very sure

2.
Check what you need to do before you make this decision.

I'm ready to take action.

I want to discuss the options with others.

I want to learn more about my options.

Use the following space to list questions, concerns, and next steps.

Credits

By

Healthwise Staff

Primary Medical Reviewer

Patrice Burgess, MD - Family Medicine

Specialist Medical Reviewer

Lisa S. Weinstock, MD - Psychiatry

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